Chemotherapy in a Patient With G6PD Deficiency and Advanced Testicular Cancer

G6PD is the most common enzymatic deficiency in humans,1,2 affecting approximately 5% of the world's population.3 Currently, there are more than 180 reported genetic variants of G6PD and its expression can vary from a mild (class V) to a severe deficiency of the enzyme (class I).3 G6PD deficient erythrocytes have difficulties in handling oxidative stress and, subsequently, are more susceptible to lysis.3 Antimalarials (dapsone, primaquine, methylene blue) are the classic therapeutic agents associated with acute hemolytic anemia but several other drugs are deemed as possible causes of hemolysis in G6PD deficient patients.2,4,5 Until the present moment, little is known about the prevalence of G6PD deficiency in cancer patients, and data regarding the use and safety of chemotherapy treatments in this population in the literature is extremely scarce.6 Here we describe the case of a young man with advanced testicular germ cell tumor treated with cisplatin-based chemotherapy (bleomycin, etoposide and cisplatin).